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Michael,how to they say in Israel? Da-khil rabak (Please in Arabic). I Hear what you say about "Japan being in trouble", Since 2008, all western countries have been in trouble. ( I watch news on NHK everyday).

This thing is, all these western countries did not get to such advanced stage of economic, cultural and social development, because they are stupid, or lead by stupid leaders. The very fact that - despite their current economic problems, they still cherish their existing social safety net, and argue little to curtail it.

They don't mind paying the higher taxes, in exchange of quality of life - live worry free. How much value would you put of emotional stress, and anxiety living under a Russian roulette, when an unexpected illness hit the family, being at the mercy of their HC insurance company, which could cut them off to fend for themselves at any moment.

Their core ideology is - Money is there to earn AND enjoy it - Not be enslaved to it.

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@Meir: "Their core ideology is - Money is there to earn AND enjoy it - Not be enslaved to it."

How has that worked out for Greece and a number of other western European nations? How is that working out for the EU? How did that work out in the former Soviet Union or Cuba since you always like off topic international comparisons that rate Cuba in a more favorable fashion than the US.

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Yes unfortunately, most people who observe other nations don't learn the simple lesson that, as Margaret Thatcher said, "eventually you run out of other people's money".Of course "they don't mind paying higher taxes". Thats because they believe it can go on forever. But right now they are protesting in the streets against "austerity". And they are losing their homes to foreclosure. Do you mind if I use your money to pay for an expensive inflated college education for my kids?Do you mind if I raise your taxes in order to make a small dent in the $16 T deficit?Do you mind if I borrow from your grand kids to pay for my $7,500 a month nursing home bill so I can stare out the window in style?

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Rob,I remind you for the 1000 times. Past financial crises and the recession followed, engulfed practically every western country., including U.S. (Notice you did not mention France & Germany)

Don't mix the USSR & Cuba with Greece or Japan. While the fist had fundamental flaw in their economic & political systems, of central planning, and no incentive for people to produce more goods and services beyond their own needs. The latter are facing financial crises much like we has here in US back in Sept. 2008.

Japan, Greece and other Western Europeans have been around for more then millennium, they are smart enough to figure out a solution best suits their need. They don't need us telling them how to maintain their quality of live. They will figure out a best solution for their people. No worry they won't go BK, and if they do, you won't have to bail them out.

Whether we like to admit it or not. the fact is "statistics" after "statistics" show that, Europeans have a better quality of life, with lower infant mortalities, longer life span, and overall happier then us here in U.S.

As I told you, for them life is not measured by dollars & cents. There is lot of to life then just cost.

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Michael, Meir cannot understand those thoughts. His ideology gets in the way and that is why when he brought up Singapore he didn't realize that Singapore had one of the freest market economies in the world and that except for Singapore which had a freer economy the per capita GDP of the US was the highest. Recognizing that we can do better Meir should review the household amenities that the poorest of Americans have because the poor in the US have more of them than comparable population groups in other countries.

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Rob,Spare me the grief ok?. My son is getting his MBA from INSEAD with campuses in Singapore, France & Dubai. It is ranked #4 best MBA in the world. I just came back from visiting there.

Yes, Singapore is one of the most free market economies in the world But their core ideology is also shared responsibility, sense of community, and giving back to society for the good of the country as a whole. they do not promote the type of selfishness & narcissism promoted by Libertarians..

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France has had chronically high unemployment for years. A few more unemployment rates to look at: Spain 26.1, Portugal 15.8, Italy 11.1 Ireland 14.7.

Germany does reasonably well, but now they have a problem. They have created rules and regulations for the EU so that they were able to export to countries like Greece who could not compete with them and who ran large debts that were in great part financed by Germany so Germany had somewhere to sell their goods (true with other countries as well.). Now Germany has to carry their debts and consider who has money to buy their products. None the less Germany has one of the best economies.

But, let us compare median incomes. The median income in the US as of 2007 was $31,000 (number 2) but Germany was only $21,000 where many goods are at a much higher price. The OECD median income was $19,229. France's median income was $19,615 just above Japan.

The US federal government subsidizes those in poverty and many programs start at 1.5 X poverty so a family of 4 will be receiving significant benefits even if they earned $34,575.

Now you got your answer about France and Germany and the best of them, Germany, has a median income of 1/3 less than the US.

I will be glad to compare the world with the US since we are number 2 median income before the crash following Luxembourg.

You write: "Japan, Greece and other Western Europeans have been around for more then millennium, they are smart enough to figure out a solution best suits their need. They don't need us telling them how to maintain their quality of live. "

That is sort of funny since it is you who is always telling everyone else to look at the rest of the world. I have looked and Americans fare very well in world comparisons. So why don't you stop with your foolish arguments that the rest of the world does... and therefore we should be doing what they do. What foolishness on your part.

"Whether we like to admit it or not. the fact is "statistics" after "statistics" show that, Europeans have a better quality of life, with lower infant mortalities, longer life span, and overall happier then us here in U.S.

You don't know what you are talking about. I have already blown holes in your infant mortality rate and life span arguments in other discussions. You just have an inability to learn. As I told you before there are many reasons for higher infant mortality rates. We try to save every life born that has a pulse. When they die they count as infant mortality. If you call them miscarriages then of course the infant mortality goes down so you are comparing apples to oranges and don't even know it.

Provide your proof, but make sure the proof matches your argument because most of the time the relationship between your proof and your argument is very thin if it exists at all.

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Rob,This is the core problem which I have with you (and other narrow minded Libertarians), you don't look beyond the skin deep issues. Everything for you is "numbers" and statistics.

You cite 25% unemployment in Spain to demonstrate, that in US, have lower rates - therefore, we are much better off then they are.

What you neglect to see (to which I am trying to show you), Unlike their American counter parts, Spanish (or the French, or the German, or Japanese), unemployed, they do not lose their right to accessible publicly funded HC - even if they lost their jobs.

So, if their little johnny gets sick, or face a catastrophic illness in the family - they don't have to add more anxiety, and stress how to pay for the Emergency life saving treatment. They are not concerned with losing their entire savings, and worse - their homes due to Medical bill. What figure do you put on that?

Here 70% of the personal BKs are due to unpaid medical bills.

Moreover, after they had lost their insurance - they need not to sneak like carpet beggars into the emergency rooms, beg for treatment. Rather, they walk with their head up, wait (if it is not life treating illness) for their turn get treated, and go home, not worry about huge medical bill, or bill collectors.

Life in America is cheap, and valued as commodity - treated like another durable goods. That is the very reason for which, you and Alvin talk of HC for people as car repair , or home replacement after a fire. Never mind, cars and homes we can replace - loved ones we can't.

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Congratulations for your son. I hope he is better with numbers, studies and statistics than you are.

Singapore is quite different from what you believe. They believe in personal responsibility and family responsibility. That is what 'conservatives' believe in. It is the leftist, the type you promote that rids a country of personal and family responsibility. Moreover the leftist nature is to break up families. You have things very backwards.

I don't know what you are trying to prove with bringing your son into the argument. INSEAD is well known and has strong relationships with about a half a dozen of the best US university MBA programs. It's nice to see that when you compare the US you compare it to the best for the rest of the world and the US still generally comes out looking good. If you don't like it here choose any other country you desire.

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I always held high regards to US MBA programs. Nevertheless, my son wanted to engage in global economy - not just the US one.

The main thrust of MBA programs in US, is mainly focused and geared to US market (and that quite fine for those who wish to work here in U.S)

95% of students at INSEAD are foreign students, from 80 different countries. To graduate at INSEAD, student must demonstrate fluency (read & write) in 3 languages.

The reason for bringing my son is, he studied in school's Singapore campus for the first part of his term, and we used to talk a lot about Singapore, their market the people and cultural. Last December we did get to visit him there, and see thing for myself.

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Meir, how many times do I have to tell you I am not a libertarian. The reason I look at numbers and studies a lot is because one wants to know a bit before they formulate a policy like you have. I understand the problems faced by many people in our country and elsewhere, but I also recognize that the social programs that we might like cost money and that is where the numbers and studies come in. You don't bother with the untended consequences because you are so narrowly fixated on your dreams and ideology.

"they do not lose their right to accessible publicly funded HC - even if they lost their jobs. "

What you neglect in your argument is the fact that those funds are paid for by those that work. If unemployment goes too high there isn't enough money to fund programs for the needy. I hope your wife handles your checkbook.

I advocate insurance so that when little Johnny gets sick he can pay for what he needs. I don't want little Johnny paying for something that only guarantees him a place in line. Moreover, if little Johnny is unfortunate and for no reason of his own doesn't have the funds I still want him to get care. Thus I want whatever money the government has to spend to be targeted to little Johnny and not to everyone which dilutes the care and leaves little Johnny on line until he dies.

Your personal bankruptcy argument due to illness is one of your typical misstatements of facts. This was the David Himmelstein study that has been debunked many times. A multimillionaire who was leveraged to the hilt and loses $50 million dollars in the stock market is considered to have gone bankrupt for medical reasons because he had more than $1,000 in medical bills that year. This is an example of the foolish things that you write. That is the type of data you have coming out of your head and that is why you are so ill informed on this and so many other subjects.

Your emotional and tearful statement about walking into the ER with ones head held high merely makes one want to laugh. That person is hoping to make it out alive and is glad that we don't have global budgeting which stops him with or without money to get the life saving treatment. Those with national health insurance that have global budgets watch the patient die when the money runs out.

Just so you don't confuse those that might be interested. We do have problems that need to be addressed in this country, but many of our problems are socio economic and almost completely unrelated to our health care system. We don't let our new borns die on the table without care merely because they are of short stature or weight and then call them miscarriages. That is what some of our European friends do. We try to save them and do for we are the best in the world in saving low birth weight babies.

We have a lot of low birthweight deliveries and deaths death because so many crack babies are born. Of course we could be like Singapore and avoid that problem by mandating capital punishment for drug traffickers and then we would have one of the best infant mortality rates in the world.

Life is not cheap in the US despite what you say and we prove it on a daily basis by keeping people alive that don't even have a good quality of life. We spend a fortune hoping for the rare event that we can do something and prevent injury or death something that is not tolerated in most other nations. Life is very expensive here in America.

But one can note that American families rich and poor have more amenities than most places; refrigerators, cellphones, large screen TV's, bathrooms and live in homes with far more square footage than elsewhere.

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Well well well. I am so....... glad to read my fellow tribesman is NOT a Libertarian. After all, we were not brought on cradles of selfishness and narcissism. Glad you had clarified it.

Statistics are importent. They are however, just one component of the overall picture - but not the whole picture what really is out there.

As for who's account whom do I listen or read for source of credible information.?

Well. I listen to those who spend major part of their lives studying the subject of HC economics. Prof (and now Senator) Elizabeth Warren of Harvard University, and her studies on why people go BK because of unpaid medical bill.

People like Steve Brill who's 36 page account of why HC here in US is so high - Time magazine (March 4) published the whole edition to this subject.

Others like T.R. Reid, A former corespondent at WashPost, who had lived in Europe and Japan (and speak fluent Japanese), and his PBS Frontline piece "Sick around the world". Where he actually traveled to 5 countries and talked directly with HC authorities in those countries and compare it to ours here in US.

I listen to people like Prof. Uwe Reinhardt of Princeton University, who actually traveled the country & abroad to learn first hand other countries HC system. He compares them to ours.

Finally. I look at WHO's ranking where France is # 1, and we are 37.

your ranking of floor space means nothing. In US HC is the biggest industry - it is business. Majority of these floor spaces are occupied by Insurance companies which contribute nothing - except act as a very expensive middleman between you and your doctor.

As I wrote to Alvin. We have pretty much exhausted this topic. You are welcome to post the last wordthanks

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Alvin, from you there is never any offense. I love reading your responses to Meir because you make so much sense. He has the vision of the anointed and is lost in fantasy. Realistic discussion of the facts at this time seems beyond his capacity.

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Unfortunately you live the life of an ideologue seldom spending any time outside of the womb. Not only that but you deal in headlines and summaries so you can't even judge for yourself what is true and what is not.

You made a claim about bankruptcies. I told you what one of the parameters was that demonstrated how wrong the headline was, but you don't deal with that because it is contrary to what you wish to believe. You tell us about Singapore and how it conforms to all your beliefs, but when faced with the fact that it is #2 with regard to economic freedom you forget about that unwilling to question your beliefs. Then when it is explained why there is more infant mortality in the US due to crack babies you go on to another topic making more errors of logic and fact. One way those crack deaths could be avoided would be capital punishment of drug pushers. I'll bet you don't support capital punishment, but Singapore is more civil according to you despite the fact that drug pushers are killed by the state. You are full of contradictions, but to protect yourself from facing those contradictions you continue to run from one thing to another without knowing what you are talking about.

Let us take one fact WHO " France is # 1, and we are 37." That is where we see the problems. You don't know what WHO is measuring.

By the way if you look again the floorspace was the living facilities of people. You simply don't read and only listen to headlines.

As far as your listening to people like Prof. Uwe Reinhardt of Princeton University. You are a name dropper and that represents the sum total of your intellect on these subjects. I so happen to communicate intermittently with Uwe and though we have little agreement I am sure he would find the way you analyze things to be grossly deficient and not worthwhile for discussion.

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David, in a monetarily sovereign nation, tax revenue pays for nothing. Think about it. The Federal government issues dollars by keystroke, and can issue as much or as little as it wants. Why would the sole issuer of our currency need revenue from taxation or selling bonds to spend on Solyndra or anything else? A paper dollar bill is nothing more than an an I.O.U. a tax credit from the issuer, the Federal government. Therefore, when gov collects taxes it simply destroys the paper since its only collecting a debt it owes itself.

So it would do well if we all stopped using the canard that taxes pay for stuff and we all need to contribute to the common good when in fact we do that when we use the government's I.O.U. to purchase goods and services for or from the government or each other.

It's all explained here by J.D. Alt,

One of the strangest things to understand about Modern Money Theory is why, if government doesn’t need your tax dollars in order to spend, does government tax at all? Here is an attempt at a new and “better” explanation. It is based on the insight that the government DOES, in fact, need to collect taxes, but the “taxes” it collects are not your “tax dollars.” This may sound like gibberish, but stick with me a moment and see if the following doesn’t make sense—and cast a new light on OTHER things as well (like, for example, the “national debt”).

A paper dollar, printed by the sovereign U.S. government, is nothing more—and nothing OTHER than—a tax I.O.U. which states, in effect: “The sovereign U.S. government owes the bearer one dollar of tax credit on the day taxes are due.”

Because of this I.O.U. pledge, the government is able to use the paper dollar, in the MEANTIME, to purchase real goods and services from private citizens and businesses. The citizens and businesses are willing to exchange their real goods and services for the paper dollars because they will NEED the I.O.U.s (dollars) to present to the government on “tax-day”. The mental “trick” here is to realize that the ACTUAL taxes are collected when the government purchases the real goods and services—those goods and services being, in fact, the actual taxes paid. (This is perfectly logical, when you consider it, because what the government WANTS are the goods and services—NOT its own paper I.O.U.s which it can print up any time it wants.)

What happens on “tax-day”, then, is the citizens present the sovereign government with the paper I.O.U.s they have earned providing goods and services to the government (and/or to each other), and their taxes are extinguished. Again, the mental “trick” here is to realize that the transaction that takes place on “tax-day” is not actually the PAYMENT of taxes but, instead, is the citizens declaring they have ALREADY paid their taxes (the real goods and services they provided earlier)—and the paper I.O.U.s are the PROOF of that payment.

By logic, then, what does the government do with those I.O.U.s presented as proof of taxes paid? They are simply destroyed because owning a piece of paper that says you owe YOURSELF one dollar of tax credit is meaningless. The I.O.U. is only of value to the citizen who is required by law to pay taxes, and once it is used for that purpose, it is extinguished.

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RB: "The Federal government issues dollars by keystroke, and can issue as much or as little as it wants. Why would the sole issuer of our currency need revenue from taxation or selling bonds to spend on Solyndra or anything else? A paper dollar bill is nothing more than an an I.O.U."

In theory I might have some agreement with you, but in practice I think you are going a bit too far. Other nations and carriers of debt determine the value of the IOU. If there is no value in it then the ability to borrow and create IOU's is extinguished.

We all agree paper money has no intrinsic value. It is the backer of that money that counts.

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Well, @Meir, you either can't read or I can't write. South Africa was brought up as an example of the existing powers fighting to maintain the status quo, since it suits them. As an answer to your comment as to, if Libertarianism is so good, why hasn't the whole planet adopted it decades ago.

Israel #51 Moderately freeJapan #24 Mostly freeS. Korea #34 Mostly freeTaiwan #20 Mostly freeand, drumroll please:Singapore #2 on the list, behind Hong Kong at #1 most free nation. This, despite the government subsidizing all the housing and medical care, they somehow keep government spending at 17% of GDP. The US, at #10, has government spending at 42% of GDP.

The point isn't that nobody has government-subsidized healthcare. The point is, besides that one piece of the liberty puzzle, you have regulations on business, regulations on foreign and domestic trade, rule of law to protect property rights, etc. etc.

There's more to liberty than just whether or not you get free healthcare.

Here in the US, many health services continue skyrocketing in price -- while elective surgeries, such as for cosmetic purposes, which isn't covered by insurance, has been coming down in price. Lasik surgery for vision used to cost a couple of thousands per eye, and now can be had for a few hundred dollars, both eyes. The insurance system in this country has the unintended consequences of pushing prices higher.

So, just because all the countries you name have got public healthcare, doesn't necessarily mean they wouldn't do better without it.

@Meir:"Perhaps we need to be reminded that, when the same party controls both houses in Congress, the W/H, and has majority in our "third" political branch, called "Supreme Court", you end up with what I dub "virtual dictatorship."

Well I can certainly agree with that! "Gridlock" is "good".

I believe there has been a study of the individual states which came to the same conclusion. States that spent the most happened to have one or the other party in control of both houses and the governorship. States with "gridlock" had difficulty enacting new legislation, so, they couldn't easily make things worse.

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I've been to Singapore a few times, but it was always on business. Business travel sounds all glamorous, but you really don't get to see much of a place on a business trip. The four inside walls of the office building could be anywhere.

And, to my surprise, libertarianism is discussed there as much as here!

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Michael,Singapore is very expensive city to live in. Beside the social conformity there, may be more stringent then you would tolerate. BUT it is a beautiful citi / state to visit. We Enjoyed the visit there.

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Alvin,Apparently the word "Free" has different meaning to you then to many others.

Free to what?. Pollute the air, or sell people tainted food, then let the "market take care of itself", after people had died?

Free to hire people with minimum wage and work them 12 hours a day under horrible conditions. Let them fend for themselves, when they get injured at work?, (as was done during the 19th century) - all for sake of free market.

The type of "freedom" advocated by Libertarians, lead to only one direction - feudalistic & unstable societies, which we have seen so many times in the past, where people rose and rioted and change the paradigm by force.

No wonder Libertarian are so enamored with the 2nd amendment, the abilty to carry gun in caseof such eventuality. LOL

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Free to do whatever you want, so long as you don't infringe on the freedoms of others.

I thought that was clear.

Yes, free to hire people at whatever wage they agree to and work them as long they agree to work. Freedom for both parties to make an arrangement they both feel is beneficial. Vs. being coerced into an arrangement which is beneficial to only one side, or to neither side.

As opposed to what is apparently your definition, where you're "free" to live a wonderful and happy life at somebody else's expense.

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Some of your observations are not free-market capitalism, but crony catitalism. The other problems you cited cannot be fixed by the free market nor by the government; you can't reasonably blame libertarianism for an imperfect world.

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The definition of freedom that you cited at the beginning of your post is not as clearcut as it appears. For example, if your neighbor likes to play music at a volume you feel is too high, then either he has the "freedom" to play music at his perferred volume, thereby infringing on your "freedom" of not hearing his music at that volume, or you have the "freedom" of not hearing his music at his preferred volume, thereby infringing on his "freedom" of playing music at his preferred volume. Thus, this catchy definition of freedom doesn't really cleanly define freedom.

While I personally agree with your concept of freedom, I ask myself, "Why can't Meir have his own definition?" In fact, recent election results and the general direction our nation is heading indicate that many people already hold Meir's concept of freedom rather than ours. Ideally, I submit that people who subscibe to fundamentally different concepts of freedom should not live in the same society, if their freedom is important to them.

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The definition is a general one. Like the saying goes, "the devil is in the details."

If you want to start dealing with the 1000's of possible permutations -- what is "harm" vs. "annoyance", etc. -- then you start to recognize just how impossible a task it would be to predefine the "best" course of action in advance for every instance, and how ridiculous it would be to try to inscribe that into law.

And no, Meir can not have his own definition, not and have successful communication with everybody else. If your definition of "blue" is the "color of grass", then we're not going to be able to talk to each other.

The problem is the English language itself. It's not a very precise language. Indeed, I imagine most human languages are not precise, although I only know English. "Free" can have definitions like "Free from Tyranny", "Free from Regulation", "Free from Responsibility", "Free from Worry" or "Free Beer."

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He can in fiction. "When I use a word,' Humpty Dumpty said, in rather a scornful tone, 'it means just what I choose it to mean — neither more nor less.'"

Is that the type of world one wishes to live in, Humpty Dumpty style? Freedom has a meaning, but those that wish to steal it from you wish to subtly change the meaning so you don't know what is happening. Sometimes freedoms collide, but that is different from freedom being stolen from you.

Meir and Humpty Dumpty have a lot in common. Meir thinks that Singapore is a very free country/ city state. It isn't. Among other things there are laws that restrict freedom of speech and violation of those laws are punished severely. It's government is a hybrid and overall has a free economic system, but politically is less than free.

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I'm not big on that scournful tone business anymore; there are no results in sight.

"Freedom has a meaning, but those that wish to steal it from you wish to subtly change the meaning so you don't know what is happening."

That's why I said people who define freedom differently should not live in the same society. That way, no one will steal our freedom and they are happy with the social order that they define--kind of like Singapore and the U.S. are two different countries. Ideally, we will further divide the U.S. along that line.

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That's why I said people who define freedom differently should not live in the same society. That's kind of like there is Greece and Spain, and there is U.S. Ideally, we will further divide the U.S. along that line.

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Dividing up is better than being forced together. There are admittedly a variety of takes on freedom; we each should be allowed to choose to go with the one close enough to our own (not necessarily identical), and be separate from those that we don't want to live under.

Moreover, rules and laws don't have to be divided geographically; you and your neighbor can live by different rules and laws if so chosen. Moreover, rules and laws can be established and enforced by private institutions.

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Dream on Eric. People join together for safety and then for mutual help. If that is not done the weak are very quickly eaten up. That was why instead of living under the Articles of Confederation our forefathers created a stronger federal government under the Constitution.

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That's the crux of what were dancing around. To what extent does a free society leave citizens to their own devices? To what extent does it "protect" them? The "gridlock" and paralysis we see today is an attempt to re-align the balance of power and keep free choice alive.An important assumption in economics is that people will make rational decisions. This is especially true when they have good information. There is more information today at our fingertips. We don't need Michael Bloomberg to outlaw large soft drinks. We know it's unhealthy. McDonald's had to start serving salad because its sales flagged during the "health boom". So you see that the free market does work, if you let it.Free speech, the Internet and our constitutional provisions are the perfect combination to combat the liberal slide toward tyranny.

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@Michael"An important assumption in economics is that people will make rational decisions."

Actually, many contemporary economists subscribe to the theory that many people many many irrational decisions. For example, how many people allow fear and greed as justification to sell low and buy high?

However, I think it matters not. Most people make rational decisions most of the time. Those who don't - end up broke and have their decisions made for them. A majority of these people learn from their mistakes and join the "mostly rational" club as well.

The most fundamental right is the right of ownership, and key to that is the freedom to choose what do with what you have. It is important for two reasons. First, the millions of decisions made by millions of citizens every day can never be duplicated by a central authority, which, by necessity, has to limit choices. Second, there is no better teacher than dealing with the consequence of poor choices.

One of the most important aspects of freedom, is being able to make poor decisions so that you can learn from them and make better choices in the future. And who is to decide what is a poor decision? Starting a "personal computer" company in your garage in the 70's sounded dumb at the time, but it worked out pretty well for Apple. If government had constrained Mr. Jobs from making a poor decision, I very much doubt if the iPhone would be in millions of pockets today.

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Speaking of government-subsidized healthcare, while it is true that many nations do have government subsidies in place to one extent or another, I don't think that necessarily lends itself to living a "care and worry free" life.

For example, Cuba is sometimes held up by the Left as a shining example of 100% government subsidized healthcare. Maybe so, but the waters off the coast of Florida are lousy with people leaving Cuba.

What I've been talking about has been the whole picture, of which government subsidized anything is part of. Subsidies by their very nature means that some people must be forced to surrender something so that somebody else can have something.

And @Meir, I know, yourself and many others willingly participate in this exchange of resources from one party to another, and I know you have the best of intentions. But then I have to ask:

If everybody is so willing to participate, why does it need to be enacted by force of law?

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There is a "subsidized" HC, and there is Single payer. Such as in Canada, Germany & France (which allows private HC clinics). which It ranked #1 HC system by OECD

While we should keep our existing free market based HC delivery, I am all for single payer system - much like Medicare.

Let the providers (hospitals, Primary Physicians and specialist doctors, as well as those who provide medical equipments, compete with each others. Take out the middleman (HC insurance companies). create one NGO or non-profit organization which will handle the payments.

It lowers the overhead cost to administrate the system, at the same time able to negotiate wholesale prices with those providers and pass on the saving to the customers.

That is the very reason cost of prescription drugs in Canada are lower then here in U.S.

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Single payer systems are not suggested for any other field of endeavor.

There are no single pay grocery stores, single pay auto dealers, or single pay construction companies. These companies not only compete among themselves, but globally for every other cost. A person is free to delay the construction of a much needed building in order to purchase what they believe is an even more needed automobile.

More needed according to *their* situation, *not* the one dictated in Washington.

Why should health care be any different? Why can't people choose to delay a medical procedure in favor of saving up for a nicer house? *That* is competition my friend. Not competition among a small clique of elite providers, competition with *everything* a person might choose to purchase.

Prescription drugs in Canada are cheaper due to Canadian price controls. Drug companies go along with it because they get most of their profit from US customers. If the US were to implement Canadian style price controls, drug companies would simply stop inventing new drugs.

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Alvin, as you know one of the very few real single payers is Canada. Meir might like to read the case of Chaoulli v Quebec. Meir might not realize, but other countries have a great deal of problems with their healthcare systems.

The ruling by Chief Justice Beverly Mclachlin stated "Access to a waiting list is not access to health care. As we noted above, there is unchallenged evidence that in some serious cases, patients die as a result of waiting lists for public health care." ... " interferes with life and security of the person "

Meir is always so concerned with the lives and security of people I wonder how concerned he is with the problem noted by the Chief Justice of Quebec in Canada.

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No my young apprentice. It is you who are mistaken - about a great many things.

Prescription drugs in Canada are cheaper, because the costs of development are borne by US citizens. In other words, the US is indirectly supplementing Canadian healthcare.

We do not have free-market HC delivery. If we did, I would be able to buy my insurance from a company outside my state of residence.

I find your idea to increase competition puzzling. Why would a hospital go through the effort to negotiate lower rates on the patient's (or insurance company's) behalf, when they can simply pass on their costs to the consumer or insurance company. Moreover, a single-payer system would reduce, not increase, competition. If you really believe that competition drives down prices, single-payer should lead to higher prices - not lower.

If you want to stimulate competition in the HC market, there are two simple reforms. First, open up competition across state lines. Second, use legislation to encourage employers to stop paying for part of employee HC costs. The current employer supplement would be given directly to the employee.

After all, it was government interference in the labor markets that spawned employer paid HC in the first place (Stock options and paid HC premiums were thought of as a way increase total employee compensation without violating wage-control laws put in place in the 1930's).

HC insurance should not be much different than auto insurance. Millions of consumers make a choice on a regular basis, which promotes strong competition - and lower prices. My auto-insurance premiums are as low as they have ever been - *even though* (I say "because") the auto-insurance market is much less regulated than the HC market.

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The Post Office is selling some old historic buildings. Now that's what I'm talking about. Time to shed the old dead weight. Slough off the old skin. Who needs marble columns and arched windows? Bring in the plastic. Bring on the virtual realities, the Internet cafes. Goodbye culture. Hello cyberspace.

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Off course Alvin. Our Libertarians friends are masters in intellectual foot dancing. For them, "freedom to whatever you want to do", is indeed freedom - as long, as they are the one who enjoy that freedom.

As Eric had pointed out, God forbid if your next door neighbor likes to listen to a type of music which you happen to dislike (as we all do). I bet, you would invoke your freedom to file a law suit with your local courthouse - complaining that, your neighbor is infringement on your "freedom" to quiet enjoyment in your home. Thus deprive him of HIS freedom to enjoy whatever music he likes in his own home.Thge core question is, who is right and who is wrong. Who's freedom is more sacred then the others.?

What I am trying to say is, life is bit more complicated, and social relationship between people, is far more complex then, simple the definition of right or wrong, as proselytized by big L's. People have different understanding, and interpretation of social norms (like "freedom").

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"For [libertarians], "freedom to whatever you want to do", is indeed freedom - as long, as they are the one who enjoy that freedom."

You deliberately mischaracterize. That freedom is for everybody, as you well should know.

"What I am trying to say is, life is bit more complicated,"

It's horribly more complicated. It's too complicated for you or anyone else to take the reins and control it.

"People have different understanding, and interpretation of social norms (like "freedom")."

Yes, as I'd said earlier, "freedom" to enjoy the good life at somebody else's expense. But where people have different social norms, they will behave differently. That's fine. It only becomes a problem when you attempt to coerce them to do something different.

As I'd asked before, if it's all such a great idea, why do you require a Law to force people to do it? Since everybody already agrees that they should contribute to the common good, then everybody should just be contributing. That government coercion is required means likely (among other things) that people say one thing but believe deep down something else.

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And yes, people have different notions of what constitutes the "common good", and libertarians say each person should all do what he/she feels is best, given their own personal situation that nobody else can decide for them.

It works out better for every field of human endeavor. Healthcare is no different. We just like to pretend it's different for myriad reasons, including an unhealthy Awe of doctors.

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"libertarians say each person should all do what he/she feels is best, given their own personal situation that nobody else can decide for them."

Actually, that is not what libertarians say at all.

Libertarians state that there are specific duties of the federal government and they are limited. They go on to believe that beyond these shared requirements, as provided by the limited duties of government, each individual has a set of natural rights. Where natural rights are in conflict with the limited shared expectations of government and the natural rights of others, we have a legal system to address the issues.

Libertarians are driven by principles and laws. Emotions and feelings are what drives another political class.

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You said: " For them, "freedom to whatever you want to do", is indeed freedom - as long, as they are the one who enjoy that freedom."

That isn't true at all. The correct sentence should read "freedom to do whatever you want - as long as it doesn't interfere with someone else's freedom." The very core of libertarianism is the Golden Rule, "Do unto others as you would have them do to you." Will you now argue that the Golden Rule is "intellectual food dancing"?

Would you mind if your neighbor played loud music at 3pm? Maybe a little, but if it's not that big a deal, then it's probably okay for you to do as well.Would you mind if you neighbor played loud music at 3 AM? Probably, so you shouldn't do it either.

Most of the time, it isn't that complicated. For those cases where it is, we have a civil justice system.

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It gets complicated as society becomes more diverse and the legal system catches up with reality. This idea of ultimate freedom is elusive. You cannot continue to dismiss its complexity by assuming that it's a piece of cake for our "civil justice system" to deal with the fallout. Historically, people conformed - or were made to conform - based on religious and legal rules. In today's world this is getting "blown to Hell."This is not a bad thing. But our gosl isn't absolute freedom. Read my comments under the topic about Diversity.

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Hard to reckon how this all relates to the Postal Service subject of the thread.

Nonetheless.

You wrote, "...use legislation to encourage employers to stop paying for part of employee HC costs. The current employer supplement would be given directly to the employee..."

Here's a further thought on the subject:

Why cannot an employer offer a direct insurance payment of a certain amount as part of their benefit package as enticement, or benefit?

The employee could specify the insurance company, and the employer might not even know the benefit plan purchased.

A minimum insurance coverage program would be mandated, and overpayment would be returned to the employer.

Just using round numbers, one company might agree to send a check for $5,000 to an authorized insurance program specified by the worker.

Another might offer a $5,500 payment as enticement to prospects.
Even higher amounts in lieu of pay increases.

If the worker wanted a better plan, he could cough up the remainder.
If he really wanted to work with an organization that offered only $3,000/yr, it might be worth it to go with them, and pay the extra for a plan he really wants.

Maybe someone who doesn’t need much insurance would opt for small payment and other considerations.

The check amount would be part of the negotiation in job application, or corporations might advertise the figures in employment advertising.

Changing jobs would not require a change in insurance providers, but – for better or worse – might change the contribution required of the worker, and could have him rethink his insurance coverage needs and budget.

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As to why people single out the post office instead of lumping it in a general pile of government:

The post office is often cited as a low cost, efficient, durable service that the government provides.

1) The government fails to factor in the per piece cost of the regular subsidies to cover the operational deficits they regularly run. Given the fairly stable business model and the known challenges, just why do they continually need to ask for incremental funds to cover unforeseen losses?

2) In order for the post office to work, we have to eliminate all other options for this service. If they would allow a greater share of competitive options or just become an oversight organization, we would have more respect.

3) We also have to endure mail box stuffing of materials very few of us want - not to mention the environmental impact of all those catalogues and mailers.

4) There are obvious cost cutting steps that the average person would be happy to support, but these options are ignored b/c of the jobs impact that these options will have, especially given the demographic make up of the post office workforce. We do not need weekend delivery service nor do we need every day delivery service. Further, there is no reason why more of the post office services could not be subcontracted. Finally, business could be charged market based rates for the crud with which they fill our boxes

5) the majority of mail that the post office delivers, could be managed through electronic means - internet and email. The balance could be handled privately at market costs.

So, if the government would just say that the postal service was just another example of an antiquated system of services we provide to ensure the size of the government workforce, then we would not single them out. As long as they list it as a government success of efficiency and service, then we will have to comment with critical exuberance.

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The same cost arguments can be applied to the defense department, NIH, Veterans, etc. However, most Americans are not aware of the implications of being monetarily sovereign; the U.S. can pay any obligation denominated in its own currency.

A monetarily sovereign government is not dependent on revenue to spend. So the entire fiasco with the Postal Service is based on greed. Private sector firms want to provide the same service at a profit, despite the Constitutional authority for a public mail service. The same is true of those wanting to eliminate public safety net programs. It's not because government is too involved, it's because the $1.5 trillion in premiums are coveted by Peterson and his hedge fund buddies. After all that's $1.5 trillion in annual, debt free, cash flow to them.

We should all support out monetary sovereignty in its true form since it is the only way to achieve debt free status. We either want government to eradicate debt or we don't. Since all money is debt money we need to use the currency creation power of the Treasury to eliminate situations like that occurring with the Post Office.

A libertarian, Constitutional solution is found in 31 USC 5112 (k) authorized in 1996 allows production and deposit of a single platinum coin into the Treasury's checking account at the Fed. The Fed then credits Treasury the face value of the coin, $60 trillion. With that amount Treasury would need annual appropriations to spend any of it. Libertarians could pressure to first pay down the national debt. Paying of the debt completely would be counterproductive, since it represents net financial assets in the private sector. Paying it down some would quell the nervous nellies believing that too much debt owed to ourselves is a bad thing.

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David Bryant."No my youngER apprentice. It is you who are mistaken - about FEW things". (LOL)

a. He...l we are NOT subsidizing R&D for Canada. This is the same lame argument, used by pundits to posit their ill informed position.

This is a free market (remember?), and no one forces the Pharma companies to sell Canadians at discount price. Canadians are using the same market forces as anyone else - they buy wholesale, and pass on the savings to their citizens. Pharams have the choice not sell them

Had our Medicare not been forbidden by law (ha ha ha free market) to do the same here in U.S., prescription drug would have been up to par to that of Canada. We are the suckers - not the Canadians. enough with blaming others for our own dysfunctional HC system.

b. "Open up competition to out of state companies" - could not agree with you more.

c. Employer HC provision. This mantra (as you alluded) was needed during the 1930's. We are in the 2013. Employers are in business to produced products, goods and serves - not in HC business. Their executives times (particularity in small business) is precious and expensive. It should be devoted to the company's interest - not shop among 1300 HC insurance companies for best policy for their employee.

Also, today there are many many talented employees stuck in a job, in which they are not happy, and their talents are underutilized. They remain in their companies due to single factor - their employers generous HC insurance which provide treatment for their sick child who has chronic decease.

Not good for the Employer. Not good for the Employee, and not good for the economy.

That is where single payer comes into play. All pay premium into one pool (non-profit or NGO organization), and chose their own primary doctors and hospitals.

Finally, I invite people to read Time Magazines May 4 edition's investigative report, where they dedicated the entire edition to explain why HC in US is so expensive, compared to other nations.

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@Meir: "This is a free market (remember?), and no one forces the Pharma companies to sell Canadians at discount price."

Yes, someone does. The Canadian government. They have price controls in effect. Drug companies sell there at the prescribed price, or not at all. So yes, the major costs of developing new drugs is borne by the US consumer.

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"Employer HC provision. This mantra (as you alluded) was needed during the 1930's"

That's how the snowball got started.

First, the government inflated the currency to pay for the war. That caused prices and wages to go up. Of course, people complained, and looked to the government to "Do Something." So they put in wage controls. To get around wage controls, employers offered benefit packages, including health insurance.

That gave the snowball a little push.

Next they made insurance tax deductible to the employer, deliberately to encourage more employers to offer it. And they did. The snowball started really rolling.

Eventually, health insurance came to cover everything from a broken leg to a runny nose. If car insurance was like health insurance, it'd cover oil changes and wax jobs. If homeowners insurance was like health insurance, it'd cover fixing a stuck toilet and painting the front door.

A hundred years ago, you went to the doctor on a stretcher.

True story: when my father was a lad, he broke his arm. His father set his arm and wrapped it in a cast. Doctor? Hospital? Are you kidding? He could still walk, what did he need a doctor for? It takes time for that kind of attitude to change. Offer people "freebies" like doctor visits for any little thing, eventually people take advantage of it.

Today, people go to the doctor for a hangnail. What do they care, the visit is covered by their employer's tax-deductible insurance. And the snowball just keeps rolling faster and getting bigger.

Eventually we come to today, where people not only expect to have "free" health care, they've come to feel it's a Basic Human Right. SOMEBODY had better take care of Little Johnny's Runny Nose.

There's no price competition because the end-consumer doesn't pay the price. So the price just keeps going up. Insurance companies try to control costs, and doctors kvetch and moan about it, but insurance companies are not the end-consumer. Ultimately, the price *will* go up. And snowball rolls still faster and gets still bigger.

So, once again, the government steps in trying to "solve" the problem they ultimately created. There are calls for "single payer" systems, "socialized medicine", etc. Eliminate those "dastardly" insurance companies who only act as expensive middlemen. There can only be three possible outcomes. The price of healthcare will just keep escalating. Or the quality will drop (which on a price per quality scale is the same thing). Or there will be third-party mandated rationing. The snowball *will* go even faster and be even bigger.

In Canada, they have all three. They control costs with price controls, and they ration healthcare so that people literally die waiting in line. Canadians with major issues that can't wait come to the US for their procedures.

Singapore has a government run health care system, and it runs well. Today. But Singapore is a new player in this whole "Western Civilization" thing. Fifty years ago, public transportation was a man pulling a rickshaw. Fifty years into the future, if they continue as now, they're going to face the same exploding costs and rationing problems that every other socialized or semi-socialized system faces today. Especially if attitudes evolve into bringing more and more ailments under the same umbrella.

So is it any wonder that a person can be bankrupted for a medical problem? Health insurance covers a runny nose, but it's too expensive to cover anything catastrophic. If the end-user is responsible for payment, then there is price competition, and that drives prices down. If the end-user is responsible for purchasing insurance, then there is price competition there as well. Affordable health insurance will cover health catastrophies, the way homeowners insurance covers total destruction in a flood or fire. Deal with your hangnail yourse...

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A single payer will not work in the current health care system where the payer is divorced from the delivery of care. You need an integrated health care system. That's why the crafters of Obama Care invented ACO (Accountable Care Organizations). But they will also fail because they are not truly integrated.I work for a fully integrated health care organization called Kaiser Permanente. Our hospitals and medical centers are staffed (not contracted); we have a single medical record: any Kaiser physician can see the patient's entire medical history, avoiding duplicate tests. There's no bill, no claim form and no insurance company. It's not a fee-for-service system: our physicians are paid a salary (and bonus) regardless of how many services or tests they order. Their bonus is based on well-known and documented quality measures. All care is coordinated and delivered in our medical centers, increasing employee productivity and satisfaction. We have a huge research database, allowing longitudinal studies. In short, we are already solving the health care cost dilemma.

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David are you saying that you don't want to join Meir's school of fractured fairy tales? [ The Bullwinkle Show ... "Bullwinkle was noted for being well-meaning, but also quite dim-witted, which made for a source of jokes during the show's run. Despite this, the so-called "moronic moose" often aided the brains of the "moose-and-squirrel" duo, Rocky, during their various adventures. Although on opposite ends of the I.Q. scale, he and the "plucky squirrel" had a shared sense of optimism, persistence and traditional ethics and moral standards.")

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Michael, Kaiser might be integrated, but I don't think it provides as good a care as it should. It has many of the bad features of HMO's (which it is) and ACO's. I know you are not at Kaiser central in California so things might be different where you are, but in California Kaiser partners keep spending down because the profits are split 50:50 between the hospital corporation and Permanente physicians so FFS is not out of the picture. If I remember correctly a few states would not permit them to open up or something of that nature because of some of their business practices.

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I've recently formulated a theory and it goes like this. Government and Private Sector are male entities. They compete with each other for the female entity - the public. Government tries to woo the public with rhetoric and policies, much like a man wooing a woman. Private sector tries to woo the public with fancy jobs and flashy lifestyle. This is why the marriage of government and business is so perverse. No longer are these two fighting each other for the attention of the public, but they've thrown aside their need for public attention and have decided instead to shack up together and ignore the public as a whole. This perverse relationship is destructive because evolution will eventually kill it. Just as man is dependent upon a woman to carry his child, government is dependent upon the public to pay taxes and keep it running. Once the government decides it doesn't need the public, both will die of starvation or failure to procreate